Michael Reese Hospital neglected, and then lost, a valuable cache of art. It looked to me like it was losing track of something even more priceless: the best interests of its patients.

An original Max Ernst vanished from the hospital where I worked in the summer of 1999. I hadn't examined it closely before it disappeared, but I remembered a silver painted wood frame around a small abstract with a red circle in its center and the unmistakable signature in the lower-right corner. I'm not sure what shocked me most: the fact that a valuable work of art had hung for years in an ailing institution, its theft, or the lack of reaction when I reported its disappearance.

I was by then the only remaining art therapist in the department of psychiatry at Michael Reese Hospital. Three other therapists in the section I directed had been laid off in the last downsizing, so I had to coax along the few to several dozen patients getting this form of treatment by myself, trying not to sacrifice too much depth.

The afternoon of the day I realized the Ernst had disappeared I walked into one of the crowded locked wards, where my fourth and last art therapy group of the day met. Valerie (all names have been changed) tossed back her black shoulder-length hair as she looked at me. The air-conditioning wasn't working, and her wide forehead was beaded with sweat. The blue hospital gown looked snug on her, and she tried to readjust the twisting sleeves on her chubby arms.

The 15 adolescents who ate, slept, and sometimes played on the ward crowded one another. Privacy was provided neither in the rooms, which had two beds each; the hallway linking them; or the dayroom, where they were under the ever-watchful eyes of the nurses in their glassed-in station. Any healthy teenager thrust into this environment would have had trouble adapting, so it wasn't surprising that the charge nurse said these kids--with their poor impulse control, depression, and penchant for risk taking--were difficult to contain. I was once a troubled kid on drugs, and though I managed to stay out of psychiatry wards, I understood these teenagers better than they realized.

Today I'd put my hopes in an institutional-size roll of heavy-gauge aluminum foil. We were going to make little sculptures by wadding the foil into tiny figures, covering them with masking tape, and painting them with acrylics. Many of the kids became absorbed in the process, sitting in silence as they compacted the foil. There was less of the usual posturing and challenging, so the staff could sit back and relax for an hour.

We were in the dayroom because it was the only space large enough for the group, and the only boundary around us was imaginary. I had to remind Jamal and Tyrone that we were a group when they started wandering off. The mental health worker sitting within earshot wasn't always mindful of the boundary either and sent Walter to his room for saying he couldn't wait to get out of there so he could "smoke blunts."

Valerie, who was 16, made her usual satanic symbol, though that day she could make it in three dimensions. I knew the five-pointed star was against unit rules because it was a gang symbol, but I didn't stop her. She'd been admitted six times to Michael Reese Hospital for cutting herself but talked little during her hospital stays about the incessant rapes and beatings she'd endured at the hands of her mother's boyfriend--why should she talk about it to people she'd see for just a few weeks? Satanic symbols were the only things she ever imagined in art therapy, and if I stopped her from making them she'd just throw more chairs at the staff. She'd also protest loudly and probably be removed from the group. That wouldn't help her.

I ignored her explanations for why she made them, given with an inappropriately bright affect. "It's a pentagram." "It's blood." "Red and black are my favorite colors."

I composed a question in my head, carefully choosing each word. "Valerie, do you think the reason you feel so attracted to these dark symbols is that, next to them, the painful things you went through seem more normal?"

She dropped her head slightly and in a soft voice said, "Yes."

I settled back in my chair, feeling relaxed--knowing the symbolic connection of Valerie with her artwork changed everything. I showed her how to hold the paintbrush so it reached into the crevices of tape.

I wanted to yell back that this was my group and that it wasn't over until I said it was, but everyone was up. Besides, a 15-year-old had said my breath was "kickin'." And I was tired, and I stank of sweat. So I said thank you to a kid who handed me containers full of colored pencils, then rode the elevator down to the deserted "expressive therapies" section, put caps back on markers, cleaned brushes, dumped dirty paint water.

When I first went looking for work as an art therapist five years ago I told myself I wouldn't be one of those eager graduates motivated by altruism who felt grateful for whatever meager salary they earned managing heavy caseloads of severely mentally ill patients in a hot, windowless basement. When my best job offer landed me in an hot, windowless basement office at Michael Reese I went through all the stages of loss. I denied it. "It's wonderful," I said. "I have my own desk." I had fits of anger, though usually not until I got home. I complained to my wife that so-and-so had tested positive for TB, but I hadn't been told until after he sneezed on me. I told myself that my colleagues were in similar situations and that my patients, including Victor, were a lot worse off.

I usually found Victor, a bony 50-year-old man with salt-and-pepper hair, slumped in an armchair on the adult detoxification ward, frowning and biting his lip. He would check himself into the hospital when he got tired of being on the street and had once again spent all of his money on crack cocaine. By then he would have also stopped taking his HIV medication.

I remember distinctly one art therapy group with Victor. When I arrived he pushed himself out of the ratty chair and slowly joined the six patients who were sitting at a table waiting for me. I handed him a stack of images--photos and art reproductions I hoped provided inspiration--and he started copying a photo of a lightning storm using tempera paint and pastels. He stood while he painted, leaning away from the table like a dancer, dabbing the paintbrush, swaying, moving in for a quick stroke. "Not bad, Victor," he muttered. "Not bad at all."

When the rest of the group finished their images, they seemed compelled to justify them. "This is my house and kids," one said sheepishly, holding up a drawing of a square house with a triangle roof and a row of stick people.

"I paint for pleasure," he declared, as if he'd painted all of his life. He stood there for a few seconds, his eyes widening in surprise, perhaps because he'd realized he could enjoy something besides crack or high-risk sex. Then his expression changed to horror, perhaps at what lay before him.

People like Victor helped me stick it out. They needed me to go on, even if the hospital couldn't afford to buy enough oranges for the children at snack time and some of them had to settle for a mealy apple.

After Victor's group, I had ten minutes to write notes in the charts and think of a plan for the next group. The company from which I'd ordered art materials had frozen deliveries to the hospital until its past-due bill was paid, so I pushed the same cart full of art materials from one group to the next, hoping no one would notice the wear on the markers and the stubby pencils.

The director and upper managers for the department of psychiatry were rarely on the floor, and I often thought it was because that allowed them to defend themselves when anything went wrong: "Why didn't anyone tell me about this?" On the adult detoxification ward, the two staff who monitored 15 patients had to prop open the door to the nurses' station to hear the phone ring. One day a patient sneaked in, grabbed a handful of Ativan vials, and injected himself with a high dose of the Valium-like drug using a woody plant stem. The patient survived, but none of the voluminous paperwork generated by the incident identified understaffing--which had allowed the hospital to show profitable financial statements to the latest corporation that owned it--as a cause.

A few weeks later on the same ward, the staff were trying to calm an agitated man, which gave another patient time to disassemble the lock on his door with his fingernails, then use a steel plate from the lock to pry open his second-floor window. He jumped and broke both his ankles on the cement walkway below.

After I'd been at Michael Reese for a year, management promoted me to head of my section, supervising three staff. I'd applied for the position thinking I might get to know more about the workings of the hospital, but the large window in my new office bought my silence for a few months.

In the 90s the hospital was sold several times as the midwest experienced "HMO penetration." Promises of better working conditions made by Humana and then Columbia/HCA quickly evaporated. In 1997 Columbia/HCA paid a network consultant to plan for a new computer system. It was badly needed, because the existing network was so archaic it was guaranteed to crash come Y2K.

The consultant marked locations for the future computers by putting little coded stickers on the walls of every office. I stared giddily at two stickers pledging a printer and a terminal in my own office. In November 1998, after the hospital had been sold again, this time to Doctors Community Healthcare Corporation, I peeled the stickers off the wall. The paint came off with them, leaving a mark.

A year later Doctors Community announced that we would be converting to a Y2K-compliant system. But in mid-December a new memo outlined the decision to "go manual" until the new system arrived. Everything had to be handwritten and hand delivered.

When the new system arrived three months later my section didn't get a computer. I bought a laptop, deciding the benefits of being able to write my own memos and access my E-mail at work outweighed the risk of it being stolen--computers were stolen regularly from the hospital. But my office phone line turned out to be digital--a vestige of an era when the section had 18 employees--so I couldn't log on.

I finished cleaning up Valerie's brushes, then splashed cool water on my face. I had enough time between doing paperwork to look for a room with a single phone line. One of the adjacent buildings had been deserted since the home-care department was closed down a year before, and only a few of the doors were locked. The employees had been escorted out in a hurry, and the rooms were frozen in time. Piles of scattered supplies amassed dust. The contents of a coffee cup fed a fuzzy covering of mold. In one corner a red bag filled with biohazard waste incubated. No one had been here in months.

I found a suitable phone jack and went on-line. It worked fine, but the room creeped me out. After checking my E-mail, I packed up my laptop. I spotted a few supplies I could use--a mail tray, a dry-erase yearly planner--but there was no one to give me permission. I left without them. It would have been too much like grave robbing.

On the way back to my office, I remembered that some rooms down the hall had been vacant since an outpatient program closed eight weeks earlier. The space didn't feel as sinister, because I'd worked with patients in the program--the ghosts were more familiar.

I'd grown tired of everyone bemoaning the lost glory of Michael Reese Hospital. To me it just looked like a miserable rat hole. An Internet search revealed that Walter Gropius, the German architect and founder of the Bauhaus, had served as a planner when Michael Reese Hospital was built in the early 50s and had greatly influenced the design. I remembered noticing a silver plaque with his name under a maple outside. The implications of working in a building Gropius had helped plan made my head swim. His words illuminated my screen: "Keep creative impulses active and effective against the deadening effect of mechanization and overorganization." Keeping creative impulses active and effective was exactly what the place was working against. "The hospital was designed with trees, gardens, light wells, recesses, and large bay windows to convey a less institutional feel." Now smoked glass hid empty rooms.

From what I'd heard, Michael Reese used to be the place for psychoanalytic treatment. In the 50s and 60s people came to it from all over the country and the world to plumb their own depths, to find out why they behaved as they did. Now patients came in to get their medication adjusted. Letters from Sigmund Freud and Albert Einstein sat under a Plexiglas case, but no one read them anymore. Every Monday drug manufacturers delivered a free lunch, some pencil holders, and a sales pitch on their latest antidepressant. The Zoloft lady brought Chinese.

Buildings by Gropius appeared on my screen, but nowhere could I find an image of the building where I worked, the Psychosomatic and Psychiatric Institute. A photo of the Harvard Graduate Center showed a strikingly similar design that was celebrated as an illustration of the Gropius style.

I packed up my laptop and headed back to my office, stopping to gaze at a print by Victor Vasarely and a stunning series by James Rosenquist hanging in an empty auditorium. I wondered how they would feel about their work hanging in that place.

I imagined that when donors endowed the nonprofit foundation of the hospital with art collections back in the 70s and 80s, they assumed their gifts would continue to inspire respect. Their donations were so extensive the art had to be hung throughout the buildings--in hallways and offices, in public and restricted areas. Hospital engineers hung the works by drilling one-way screws through the frames. I heard from Bernard, a soft-spoken psychologist, that when the hospital was sold in the late 80s or early 90s the engineers were ordered to remove the artwork from a wing of the building. They pried the works off the wall and locked away great piles of them in the boiler room, the screws still in their frames.

A few months after I was hired I wandered into that boiler room. I saw the screws sticking through torn canvases and curly flakes of oil paint that had been raised by the intense heat. I marched to the director's office, but she received the news with passive fatalism. No one else seemed to see the connection between the neglect of this artwork and the treatment of the fragile humans on the locked wards.

Around that time I first saw the Max Ernst. It was hanging by a door in the intake department. When I hinted at its potential value, the department head moved it into his office, where he hung it on a nail. I was encouraged to investigate further by administrators who suddenly realized there might be unknown capital in the building. I made a few calls, and in February 1998 the regional chairwoman of Sotheby's made a courtesy visit. She confirmed that the Ernst and the series of Rosenquist prints were worth tens of thousands.

During the summer and fall of that year, Tribune articles about the upcoming sale of Michael Reese Hospital chronicled its decline. Feeling as if I were under a giant magnifying glass, I kept working and tried to ignore the rumors. The hospital will be turned into condos. Jesse Jackson and the Rainbow/PUSH Coalition want to buy.

Finally I read in the paper that the winning bidder, Doctors Community, had financed the bulk of the transaction by selling the hospital's unpaid bills to a financing company, and as soon as the purchase was final the hospital began cutting costs even further. A memo circulated that asked employees to throw away their own trash and to clean nonpatient areas themselves. Salaries for all doctors were suspended until further notice, and many resigned. Staff and management were laid off in waves. By May I was alone in my section.

My job often seemed absurd. One day I had a group on the large, 28-bed adult ward on the second floor. It was the worst unit to work on, because profoundly retarded people shared the space with demented elders, the homeless and addicted, and depressed professionals who stared at the other patients in disbelief. It was impossible to group patients by how well they functioned or by what kind of issues they were dealing with.

Vinyl creaked as Sylvia, who was profoundly retarded, twisted herself around in her chair to see who'd entered, and she let out a characteristic squawk that sounded a bit like a crow's. Her yellow front tooth jutted out at me.

"Hi, Sylvia!" I said, taking her outstretched hand in mine. "I'll be back in just a minute, after I tell the other patients that we're having a group."

The vinyl creaked again as she twisted around to watch me walk down the hallway. On TV, Montel Williams was blasting questions at a cheating husband, and the nurses' station was abuzz with chatter and the intermittent whir of the dot-matrix printer. Staff behind the pink countertop barked orders at the patients.

I knocked on doors at the end of the hallway and announced myself, but most of the rooms were empty. A woman strapped to the bed in the seclusion room heard me knocking and started howling for help, her voice quickly rising to an earsplitting scream. My stomach knotted up. I glanced at the door to her room and saw that a piece of computer paper covered the little window.

As I walked back into the dayroom a tall man in green pajamas was shuffling around the tables giggling. He stopped and smoothed his shiny brown face with his hand, going back and forth over the gray stubble on his chin. He turned his head slightly, as if trying to hear something. I smiled at him from the other end of the room, but he was too absorbed to see me. Then he let out a rippling fart and started shuffling around the tables again, laughing in short bursts. A few patients, including Victor, were already drawing at the table and didn't seem to be bothered by the smell. Sylvia was the only one protesting, bellowing the only word she'd ever mastered--"Eaaaat! Eaaaat!"--and pounding the table with her fist.

A woman walked gingerly into the dayroom, her long, greasy blond hair caked on one side of her head in a vertical spiral. She looked around tensely, and when her wide eyes caught mine I smiled at her.

"Leave me alone!" she screamed at the top of her lungs. "Why are you trying to kill me?"

"Jill! They're having a group right now," a nurse behind the pink counter warned. "If you're not gonna participate, you need to go back to your room!"

I guess you could call this a group, I thought.

"You're preaching!" Jill screamed at the nurse. "You're preaching! Why are you trying to kill me?" But she walked back to her room.

After 20 minutes I taped the drawings to the wall. One woman got up without a word and started leaving the dayroom.

"Are you coming back?" I asked. She kept walking and was soon out of sight.

"She always does that," Victor said. "She can't talk."

"All right," I said. "Could you get up now and walk around the room to have a look at the art that's been made?"

Chairs scraped the linoleum tiles as people got up. We stood in silence, looking at the ten or so images. The woman in the seclusion room started screaming for help again. The printer whirred away.

"So?" I inquired after what seemed an eternity. "Anybody?"

The tall guy in green pajamas shuffled over to us and farted.

"Is this fart therapy?" Victor chided him.

"OK, folks," the nurse yelled from the counter. "It's smoking time!"

The group disintegrated as patients shuffled over to the smoking room like zombies. The tall guy stuck his butt out slightly and farted again, a high-pitched whine that lowered to a final trumpeting blast.

I prayed secretly that the hospital would close, so I could get some rest on unemployment before I went nuts. But after a few months I realized it wasn't going to happen.

Three months after the new administrators started, in the summer of '99, I hadn't been called to a single meeting, so I decided to start meeting with them. On my way to the director's office I noticed the nail for the Max Ernst sticking out of the wall, but the painting was gone. I went to the boiler room and found the door ajar, the floor bare. Even the damaged artwork had disappeared.

"What do you want me to do about it?" the director said abruptly, adding that anything that wasn't bolted down would end up stolen. Then we talked about my schedule, and despite my protests, she added several back-to-back art therapy groups. As I left she said, "This vanishing-painting business--it sounds like one of the Nancy Drew novels I used to read."

I filled out a form for the missing artwork, even though I knew it was pointless. Thieves used the unguarded entrances to a drab tunnel that ran the length of five city blocks under the whole campus to steal computers from the various hospital buildings. One section of the tunnel was so long it vanished into a point. I got a sick feeling walking through it to the cafeteria during cold winters. The concrete floors were cracked and stained here and there by some dark, sticky fluid. The Dumpsters lined up against the tiled walls stank. The fluorescent ceiling tubes buzzed, and the ultraviolet lights illuminated piles of biohazard bags on the loading dock.

Before the staff education program was terminated at the end of the year and Bernard was laid off, he told me that one summer weekend night years before, two teenagers had taken one of the electric carts for a joyride in the tunnel. It was a heavy machine the size of a golf cart, used to tow trains of Dumpsters to the docks. When a panicked employee called security, the officer who answered said he couldn't leave his post because he was the only one on duty in the hospital. The teens eventually careened the cart into a tunnel wall, where it left a gaping hole.

When the psychiatry wards called security to respond to a disturbance they couldn't handle themselves, the officers were always slow to arrive. They were supposed to leave their guns in a safe before they entered the locked wards, but the keys to the safes had been lost a long time ago. In a place that had a different lock on almost every door, innumerable keys were now unaccounted for. With the layoffs, hundreds had been turned in to supervisors, who were then laid off themselves. The entire hospital was vulnerable, but engineering said the cost of replacing every lock was prohibitive. Hospital security froze every key order, making it almost impossible to get a key made.

For a while when we called security the receptionist would place the loaded guns in her front desk drawer. Then she was laid off. The new receptionist refused to be responsible for the guns, which meant that security officers had to leave them in an unlocked drawer in a pantry right outside the wards. The door to the pantry was locked, but every employee had the key to it. Except the officers, who propped the door open with a food cart.

I told the director how easy it would be for a disgruntled employee to grab a gun and go on a shooting rampage. Or one of the visitors, who could be as emotionally unstable as their relatives on the wards.

The disappearance of the Ernst seemed emblematic of how the resources of the hospital had dwindled further under each successive corporate owner, while the cultivated atmosphere of crisis grew. The more patients the hospital treated, the more management invoked lack of resources for its failure to address urgent problems. Worker discipline, already a well-established process, became noticeably more efficient than the other protocols needed to run the hospital. Employees who became too critical of conditions that made it difficult to care for patients were promptly punished into submission or fired. Others learned helplessness as a condition of their employment. What bothered me most was that hospital administrators maintained that all of this was customary.

At the end of the day when I noticed the Ernst had vanished I cleaned a vacant office in my section that used to belong to a secretary. Plowing through cobwebs and layers of old supplies, I spotted a fragment of brittle paper bearing the caduceus, the emblem of the medical profession. Hermes, I thought. God of commerce, thieves, and writers.

The office had a safe and a lockbox that was bolted to the door, neither of which had been opened in years. In a coffee cup full of pens and dust, I found a set of keys, one of which fit the lockbox. I opened the lid and saw that the box was full of keys. I burst out laughing--only after I'd lost every employee in my section did I find the keys to every door. There was even a key to the safe, but two keys were needed to open it. I called security, hoping they had the other key. They did.

An officer showed up 20 minutes later and we simultaneously turned our keys. The safe clicked, and the door opened, revealing an assortment of pen caps and paper clips and two envelopes. One was marked "Adolescent Allowance" and contained a $20 bill, and the other bore a name and the note "$60 Savings from Allowance Money," with "savings" underlined. It indeed contained $60. Apparently, whoever underlined "savings" wanted to make sure this teenager received his patiently accumulated allowance money upon discharge. The envelope had to be from the 80s, when the hospital could afford to give patients money to buy snacks and magazines from the gift shop.

Later I checked the hospital's records and discovered that the young man had stayed for six weeks 11 years earlier. I was strangely ecstatic at the prospect of calling the man, who should have turned 28, to tell him I had $60 to give him. But none of my searches yielded a listing for the name.

The nurse manager had a suggestion. "Lunch is on you," she said. "For all I care, you can have a party!"

I decided I wanted to buy some videos about artists--Horace Pippin, maybe Diego Rivera--something I could use in art therapy. I also decided that if I ever found that man I'd give him the $60--symbolic restitution for every promise the hospital had made its patients and had then broken.

Note: Martin Perdoux recently resigned his position at Michael Reese Hospital; he now teaches woodworking at Hillside Academy and art therapy classes at the School of the Art Institute.

Art accompanying story in printed newspaper (not available in this archive): illustration/Teresa Mucha.